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Individual

MR. GORDON FREDRICK SMITH II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
2593 US HIGHWAY 2 E, SUITE 6, KALISPELL, MT 59901-9507
(406) 257-0933
(406) 257-3426
Mailing address
2593 US HIGHWAY 2 E, SUITE 6, KALISPELL, MT 59901-9507
(406) 257-0933
(406) 257-3426

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1227
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
150880200
DEPT OF LABOR
MT
05
3400488
MT
01
60466
BC BS
MT
Enumeration date
11/07/2006
Last updated
06/20/2013
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